Provider Demographics
NPI:1508867565
Name:WARNER, MAURICE J (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:MAURICE
Middle Name:J
Last Name:WARNER
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1926 OAK ST
Mailing Address - Street 2:P.O. BOX 389
Mailing Address - City:UNIONVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63565-1180
Mailing Address - Country:US
Mailing Address - Phone:660-947-2411
Mailing Address - Fax:660-947-3825
Practice Address - Street 1:1926 OAK ST
Practice Address - Street 2:
Practice Address - City:UNIONVILLE
Practice Address - State:MO
Practice Address - Zip Code:63565-1180
Practice Address - Country:US
Practice Address - Phone:660-947-2411
Practice Address - Fax:660-947-3825
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO040491183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist